In the age before Hyalase (or more accurately Hyaluronidase) became easily available, over injection of fillers was a nightmare most aesthetic doctors had to deal with pretty regularly. Luckily the fillers of that age didn’t last so long and most doctors weren’t so adventurous, sticking mostly to the nasolabial folds.
In that era (circa 2002-2005), some of us had to resort to using lasers and IPLs to dissolve the fillers, which of course didn’t work. We now know better and have stopped advocating lasers to “dissolve” fillers”. But the lesson learnt allows us to confidently use skin tightening devices like Ulthera together with fillers without the fear of destroying the fillers.
Now with hyaluronidase available, however, we can infinitely adjust fillers as long as they are made of hyaluronic acid. Too much and we will dissolve some of it away. Too little, we can inject some more. This gives us us accuracy and precision to venture into more hallowed areas like the tear trough and the marionette lines.
The hyaluronidase instantly dissolves the fillers in situ. It breaks Hyaluronic acid down into simple sugars that can easily be absorbed into the bloodstream or the lymphatic system. After several days when the hyaluronidase has been reabsorbed and any swelling has subsided, we can do the corrective adjustments for the areas as some of the surrounding will also be inevitably be affected.
Hyalase gave us the ability to infinitely adjust any filler treatments, gave us rise to the art of facial sculpting with fillers which we have termed the Liquid Facelift.
Photo Credit: Galderma Restylane